title: Prestroke alcohol consumption and smoking are not associated with stroke severity, disability at discharge, and case fatality.
abstract: BACKGROUND
  Heavy alcohol consumption and smoking are known risk factors for stroke, but their influence on stroke severity and outcome may also be important. We tested if alcohol consumption and smoking relate to initial stroke severity, disability at discharge from hospital, and outcome at 30 days and at 1 year in 1049 patients of the Mures-Uzhgorod-Debrecen database.
  
  
  METHODS
  Initial stroke severity was scored by the National Institutes of Health Stroke Scale. Case fatality and the modified outcome scale of the First International Stroke Trial were used to assess outcome. We used multiple regression analysis.
  
  
  RESULTS
  Before their stroke, 24.5% were smokers and 24.7% admitted regular alcohol consumption. Neither smoking nor alcohol consumption status was associated with initial stroke severity. Case fatalities at discharge, at 30 days, and at 1 year were 12.2%, 16.9%, and 28.3%, respectively. Initial stroke severity, hemorrhagic subtype, and age in men over 60 years were strong predictors of outcome. We did not find significant difference among alcohol consumers and nonconsumers in 30-day and in 1-year case fatality in all stroke patients and in ischemic stroke patients. In hemorrhagic stroke, there was a nonsignificant tendency for higher case fatality among alcohol consumers (39.5% versus 26.4%, P > .2, at 30 days and 48.8% versus 35.8%, P > .2, at 1 year). Smoking did not influence significantly the outcome at 30 days and at 1 year.
  
  
  CONCLUSIONS
  Despite being risk factors, prestroke smoking and alcohol consumption do not have a significant influence on stroke severity and on short- and long-term outcome.
authors.affiliation: Department of Neurology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary.
authors.forename: Klára
authors.initials: K
authors.lastname: Fekete
authors.affiliation: Department of Neurology, Clinical County Emergency Hospital, Târgu Mures, Romania; Department of Neurology, University of Medicine and Pharmacy, Târgu Mures, Romania.
authors.forename: Szabolcs
authors.initials: S
authors.lastname: Szatmári
authors.affiliation: Department of Neurology, Clinical County Emergency Hospital, Târgu Mures, Romania.
authors.forename: Ildikó
authors.initials: I
authors.lastname: Szőcs
authors.affiliation: Department of Neurology, Clinical County Emergency Hospital, Târgu Mures, Romania.
authors.forename: Csilla
authors.initials: C
authors.lastname: Szekeres
authors.affiliation: Department of Neurology, Clinical County Emergency Hospital, Târgu Mures, Romania; Department of Neurology, University of Medicine and Pharmacy, Târgu Mures, Romania.
authors.forename: József
authors.initials: J
authors.lastname: Szász
authors.affiliation: Department of Neurology and Toxicology, B.A.Z. County Hospital, Miskolc, Hungary.
authors.forename: László
authors.initials: L
authors.lastname: Mihálka
authors.affiliation: Department of Neurology and Neurosurgery, University of Uzhgorod, Uzhgorod, Ukraine.
authors.forename: Volodymyr
authors.initials: V
authors.lastname: Smolanka
authors.affiliation: Infection Control Unit, Kenézy Hospital, Debrecen, Hungary.
authors.forename: László
authors.initials: L
authors.lastname: Kardos
authors.affiliation: Department of Neurology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary.
authors.forename: László
authors.initials: L
authors.lastname: Csiba
authors.affiliation: Department of Neurology, Semmelweis University, Budapest, Hungary. Electronic address: bereczki@neur.sote.hu.
authors.forename: Dániel
authors.initials: D
authors.lastname: Bereczki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects*; D002545:Brain Ischemia / Q000150:complications / Q000401:mortality / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000150:complications / Q000401:mortality / Q000473:pathology; D016208:Databases, Factual; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D020521:Stroke / Q000150:complications / Q000401:mortality / Q000473:pathology*; D016896:Treatment Outcome
keywords: Stroke; alcohol; outcome; severity; smoking